Sexual Assault Prevention Efforts in the U.S. Air Force: A Systematic Review and Content Analysis

Abstract:

Background: Sexual assault in the United States military has received much public attention in recent years, especially in light of the 2012 Sundance award winning documentary, The Invisible War, highlighting the epidemic. DoD estimates over 26,000 cases of sexual assault occurred in 2012 and sexual assault reporting increased 50% from 2012 to 2013 yet there has never been an objective evaluation of any of the service sexual assault prevention programs.  This study examined the four iterations of Air Force sexual assault prevention programs and compared them to best practices found in effective sexual assault prevention programs in the current literature.

Method: A systematic review and meta analysis of sexual assault prevention literature was conducted.  Subsequently, a detailed review and analysis of the contents of the four versions of the Air Force sexual assault prevention programs was conducted by two independent researches, both with PhD level research training. A coding scheme was developed and the content of the curriculum was grouped into three categories: content, process, and outcomes with the coding done on a binary system. Data found in the curriculum was therefore codes as either “present” or absent”. Inter-rater reliability for this analysis suggested a high level of agreement (Kappa = .90, 95% CI: 0.85-0.95).

Results: While the degree of compliance with best practices varied across the program years, and increased from a low of only 19.7% compliance in the 2005 program to a high of 60.6% compliance in the 2014 program, the improvement was not linear, giving cause for some concern. In particular, some versions of the training revealed a decrease in compliance from previous years, and also had elements that have been shown to be iatrogenic. Preliminary results from a study on the Air Force sexual assault prevention program will also be discussed.

Conclusions and Implications: To date there has been a dearth of research on military sexual assault prevention programs despite the increased rates of incidence and reports and a concentrated prevention effort.  Even though the Air Force implemented four discreet prevention programs in the past 10 years, there is no evidence of efficacy of any of the programs or a theoretical framework that guides the contents.  Further, there is no evidence of a standardized delivery process for this Air Force wide program. Research indicates certain elements of the training are not only not effective but some components may be potentially harmful, especially to vulnerable populations that may have experienced sexual assault.  This study, the first to explore and analyze content for military sexual assault prevention, lays the foundation for additional research in this area and provides recommendations incorporating key elements of other prevention programs that could enhance effectiveness. The results of this content analysis will serve as a baseline for future studies. These studies should focus on robust objective process as well as experimental outcome evaluations to determine the efficacy of U.S. military sexual assault prevention programs.